The Middlesex-London Health Unit is currently under a province-wide Stay-At-Home Order
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COVID-19 Guidance and Resources for Long-Term Care Homes and Retirement Homes

Note: Long-Term Care and Retirement Homes should contact their Middlesex-London Health Unit investigator with any questions or concerns regarding COVID-19 or other infectious diseases by calling 519-663-5317.


 

Guidance for Long-Term Care and Retirement Homes

Visitors to Long-Term Care Homes and Retirement Homes: COVID-19 Response Framework

The provincial government has released the COVID-19 Response Framework which categorizes public health regions into five levels: Green/Prevent, Yellow/Protect, Orange/Restrict, Red/Control, and Lockdown. The rules for visitors will vary based on the level of the local public health unit region in which the home is located. Additionally, the local public health unit may provide direction and/or restrictions on visitors to the home. 

London and Middlesex County are in a Province-wide Stay-at-Home Order effective April 8, 2021.

Review the following for guidance on visitors:

Guidance for Long-Term Care and Retirement Homes from the Middlesex-London Health Unit

The Middlesex-London Health Unit strongly recommends the following for all Long-Term Care Homes (LTCHs) and Retirement Homes (RHs) in London and Middlesex County:

  • Student placement and activities in LTCHs and RHs must cease for the duration of an outbreak unless there is critical need for staff such that students are necessary for ongoing operation. In this instance, students will then be treated as 'employees' and will not be permitted to train or work at any other health care facility.
  • Residents should wear a mask anytime they are outside of their rooms.

Additionally, given the rising incidence of COVID-19 in the community, the Middlesex-London Health Unit has updated its quarantine guidance for household members of individuals with COVID-19-like symptoms. All household contacts of symptomatic individuals are to quarantine while awaiting the test results of the symptomatic individual. For Long-Term Care and Retirement Homes, the follow guidance now applies:

  • If a staff member's household member is symptomatic, the staff member should not go to work until the symptomatic person's test results are known.
  • If the test results are negative, the staff member may return to work and their normal activities and monitor themselves for the development of symptoms.
  • In exceptional circumstances where clinical care would be severely compromised without additional staffing, work-quarantine may be considered. Additional directions on work-quarantine can be found here.

COVID-19 testing for LTCHs and RHs

Long-Term Care Homes

For full details about long-term care home surveillance testing and access to homes, please read the Minister's directive.

Staff, Caregivers, Students Placements and Volunteers

All staff, students and volunteers working in a LTCH, when taking a Rapid Antigen Screening Test, must take it as soon as practically possible once their shift begins. Anyone who has a positive screening result will need to leave the home and seek a PCR test within 24 hours.

Please see the frequency of testing below:

Frequency of Entering a Long-Term Care Home Test Frequency
Two or more days in a 7-day period

One PCR test and one antigen test on separate days within a seven-day period

OR

An antigen test at a frequency described in COVID-19 guidance: Considerations for antigen point-of-care testing

Once in a 7-day period "Day of" their visit 
Twice in a 7-day period on consecutive days If an antigen test is taken on the first day, entry may be permitted on the second, consecutive day without another antigen test

Support Workers, and General Visitors

All support workers and general visitors must demonstrate they received a negative COVID-19 test result from an antigen test on the day of their visit or provide proof they received a negative test result on an antigen test taken the previous day while visiting.

Retirement Homes

All retirement homes should have their entire staff participate in ongoing surveillance testing.

  • All individuals working in the retirement homes (e.g. front-line workers, management, food-service workers, contracted service providers, basic aids, and guest attendants) should be tested biweekly.
  • Staff can be tested at an Assessment Centre.
    • The retirement home must provide each staff member with a requisition form for testing. For details on how to complete the requisition, see this link. This form must include an assigned investigation number (INV) for use by the Assessment Centre.

COVID-19 swab ordering process:

Healthcare Materials Management Services (HMMS) has assumed the distribution and delivery of COVID-19 swabs to all organizations across Ontario.

  1. Complete this electronic form and submit it online. HMMS will fulfill order requests within 72 hours and will have the COVID-19 swabs delivered to your facility.
  2. To ensure enough COVID-19 swabs are available for all organizations, please restrict orders to a maximum of 110% of your resident and staffing numbers combined, over a one-week period.
  3. If you have any questions or concerns regarding this process, contact HMMSCovid19@hmms.on.ca 

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Personal Protective Equipment (PPE)

Staff masking:

  • All staff and essential visitors must wear surgical/procedure masks at all times for the duration of full shifts or visits in the long-term care and retirement home.

The following videos provide a refresher on the correct procedures for donning and doffing:


Email Updates and Alerts

The staff of long-term care and retirement homes can subscribe to receive email updates and alerts by emailing healthcareproviders@mlhu.on.ca with the subject line "add to LTC and RH distribution list" and let us know at which facility you're employed. To read previous alerts sent by email, please click the link below.

See Past Alerts (Email Archive)

 

Guidance Documents

For general guidance on: Environmental Cleaning, Personal Protective Equipment, and Infection Prevention and Control; Screening, Symptoms, Testing, and Case Management; and Quarantine and Self-Isolation, visit the Guidance and Setting-Specific Resources for Healthcare Providers and Institutions. 

 

 

 
Long-Term Care Homes and Retirement Homes Date

Using Ventilation and filtration to reduce aerosol transmission of COVID-19 in long-term care homes (Government of Canada)

April 12, 2021

COVID-19 Directive #3 for Long-Term Care Homes under the Long-Term Care Homes Act, 2007 (Chief Medical Officer of Health)

April 7, 2021

COVID-19 Directive #5 for Hospitals within the meaning of the Public Hospitals Act and Long-Term Care Homes within the meaning of the Long-Term Care Homes Act, 2007 (Chief Medical Officer of Health)

April 7, 2021

Interim Guidance for Infection Prevention and Control of SARS-CoV-2 Variants of Concern for Health Care Settings (Public Health Ontario)

April 2021

COVID-19 Guidance: Considerations for Rapid Antigen Screening (Ontario Ministry of Health)

March 19, 2021

COVID-19: Long-term care home surveillance testing and access to homes (Ontario Ministry of Long-Term Care)

March 15, 2021

Quick Reference Public Health Guidance on Testing and Clearance (Ontario Ministry of Health)

March 5, 2021

COVID-19 Vaccine Promotion Toolkit (Ontario Ministry of Long-Term Care)

Available in additional languages

March 1, 2021
COVID-19 Directive #5: Questions and Answers (Ontario Ministry of Health) February 19, 2021
COVID-19: Visiting Long-Term Care Homes (Ontario Ministry of Long-Term Care) December 29, 2020
Retirement Home COVID-19 Visiting Policy  (Ontario Ministry of Long-Term Care) December 11, 2020
Visits with Residents: A Checklist for Homes (Ontario Ministry of Long-Term Care) September 9, 2020
Limited Visits During a COVID-19 Outbreak (Ontario Ministry of Long-Term Care) September 9, 2020
Guide for Visits (Ontario Ministry of Long-Term Care) September 9, 2020
Frequently Asked Questions: COVID-19 Visiting Policy (Ontario Ministry of Long-Term Care) September 2, 2020
Posters to Retirement Homes (Government of Ontario) July 20, 2020

COVID-19 Test Requisition (Ontario Health)

*Note: these instructions are for how to properly complete a test requisition form.  The form itself can be found here

June 12, 2020
COVID-19 Patient Screening Guidance Document (Ontario Ministry of Health) June 11, 2020
New Admissions and Readmissions to Long-Term Care Homes (Ontario Ministry of Long-Term Care) June 11, 2020
COVID-19 Surveillance Testing – Guidance Regarding Retirement Homes Staff and Resident Testing (Ontario Health) June 9, 2020
De-escalation of COVID-19 Outbreak Control Measures in Long-term Care and Retirement Homes (Public Health Ontario) June 6, 2020
Prevention and Management of COVID-19 in Long-Term Care and Retirement Homes (Public Health Ontario) June 5, 2020
COVID-19 Screening Tool for Long-Term Care Homes and Retirement Homes (Ontario Ministry of Health) May 6, 2020
Limiting Work to a Single Long-Term Care Home (Ontario Regulation) April 16, 2020
COVID-19 Action Plan for Protecting Long-Term Care Homes (Office of the Deputy Minister) April 15, 2020
Memorandum to: Health System Organizations and Providers, Re: Update on COVID-19 Preparations and Actions (Office of the Deputy Minister) April 15, 2020
COVID-19 Outbreak Guidance for Long-Term Care Homes (LTCH) (Ontario Ministry of Health) April 15, 2020
Guidance for Mask Use in Long-Term Care Homes and Retirement Homes (Ontario Ministry of Health) April 15, 2020
COVID-19 Guidance: Long-Term Care Homes (Ontario Ministry of Health) April 15, 2020
Work Deployment Measures in Long-Term Care Homes (Ontario Regulation) April 14, 2020
Work Deployment Measures in Retirement Homes (Ontario Regulation) April 2, 2020
Infection Prevention and Control for COVID-19: Interim Guidance for Long Term Care Homes (Government of Canada) Check link for updates
 
Date of creation: April 2, 2020
Last modified on: April 7, 2021